Allergic rhinitis is a very common chronic illness affecting 10% to 40% of children worldwide. There has been a significant increase in prevalence among children over the last two decades and this increase has been accompanied by a parallel increase in comorbid illnesses such as asthma. Symptoms include sneezing, itching, runny nose and nasal congestion. Allergic rhinitis may be defined as 'persistent' or 'intermittent'. These classifications loosely correspond to perennial (all year round) allergic rhinitis and seasonal allergic rhinitis ('hay fever'). There are a wide range of drug treatments available including topical and oral decongestants, topical and oral antihistamines, topical and systemic corticosteroids, leukotriene antagonists and a number of over the counter preparations. Topical steroids (nasal sprays) are often prescribed, and act directly on the nasal mucosa to reduce symptoms.
The authors of the review identified a large number of randomised controlled trials, however many were excluded due to the use of 'rescue' (additional) medication, which may have confounded the results.
The three included trials provided some weak and unreliable evidence for the effectiveness of Beconase® and flunisolide used topically in the nose for the treatment of intermittent and persistent allergic rhinitis in children. The review authors concluded that until more research is available, decisions on the use of topical steroids should be guided by the physician's clinical experience and patients' individual circumstances and preferences.